MODERN DENTAL PROFESSIONALS UTAH PC
NPI: 1912066424
· SALT LAKE CITY, UT 84111
· General Practice Dentistry
· NPI assigned 12/08/2006
Deactivated NPI
· This NPI was deactivated on 04/08/2024. Reactivated 01/06/2025.
1,593
Beneficiary Records
Provider Details
| Authorized Official | CAHOON, KEVIN (OWNER) |
| NPI Enumeration Date | 12/08/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
2,160 |
$57K |
Billing Codes
| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
210 |
194 |
$17K |
| D1351 |
Sealant - per tooth |
482 |
58 |
$7K |
| D1120 |
Prophylaxis - child |
202 |
192 |
$6K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
111 |
53 |
$6K |
| D0274 |
Bitewings - four radiographic images |
208 |
199 |
$6K |
| D0120 |
Periodic oral evaluation - established patient |
145 |
141 |
$5K |
| D1110 |
Prophylaxis - adult |
99 |
96 |
$4K |
| D1206 |
Topical application of fluoride varnish |
262 |
248 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
214 |
197 |
$2K |
| D0210 |
Intraoral - complete series of radiographic images |
51 |
47 |
$861.00 |
| D0140 |
Limited oral evaluation - problem focused |
12 |
12 |
$454.88 |
| D0230 |
Intraoral - periapical each additional radiographic image |
164 |
156 |
$122.62 |